We are well served in Aotearoa with health professionals who are committed to caring. My experience over the years as a trainer of counsellors and therapists and as a provider of counselling and therapy services has engendered a major concern. The territorial imperative operates in our health professions and keeps us isolated in our practice settings. This leads to a system of referrals which frustrates clients and establishes a hierarchy of care with medical personnel at the top. When I worked in a team consisting of medics, therapists, occupational health practitioners, mental health nurses, psychiatrists and social workers each client was approached and helped using a wide perspective. It promoted a holistic approach to health which took account of the whole person including their spiritual needs, cultural belongings and social interactions. None of us should be working alone. None of us should be making decisions about people without the benefit of consultations with other professionals who have been trained differently. We speak about systemic views being important, we acknowledge there is no separation between mind body and spirit and we believe people are socially orientated and benefit from living successfully in families. When people consult us we keep to our territory and perhaps make a referral to another health specialist. At that point there is little communication between professionals and the client is left to make the links between, for example, a therapist and a general practitioner. I look forward to the day when teams are the norm in health and separate territories a feature of the past. A. Roy Bowden, July 009
